Medication Administration Safety

National Patient Safety Goals

• The National Patient Safety Goals are a set of objectives created by The Joint Commission to improve healthcare and patient safety.
• The goals are developed annually and are designed to guide healthcare organizations in improving patient care and safety.

Objectives of the National Patient Safety Goals

• Patient Identification: Ensure accurate identification of patients to prevent errors.
• Improved Communication: Improve communication among healthcare providers to prevent errors.
• Medication Safety: Ensure safe administration of medications to patients.
• Clinical Alarm Safety: Ensure proper use of clinical alarms to prevent harm to patients.
• Healthcare-Associated Infections: Reduce the risk of healthcare-associated infections.
• Reducing Falls: Reduce the risk of falls among patients.

International Patient Safety Goals

• Goal One: Improve the accuracy of patient identification.
• Goal Two: Improve the effectiveness of communication.
• Goal Three: Improve the safety of high-alert medications.
• Goal Four: Ensure correct site, correct procedure, and correct patient surgery.
• Goal Five: Reduce the risk of healthcare-associated infections.
• Goal Six: Reduce the risk of patient harm resulting from falls.

Goal One: Identifying Patients Correctly

• Patient identification errors are a major threat to patient safety.
• The Joint Commission International (JCI) recommends using at least two patient identifiers when obtaining blood samples or administering medications.
• The World Health Organization (WHO) recommends integrating information technology, improving healthcare workers' training, and raising awareness among patients and families.

Goal Two: Improving Effective Communication

• Effective communication is essential for preventing patient harm.
• The Joint Commission recommends using the SBAR (Situation, Background, Assessment, and Recommendation) tool to standardize communication.
• The SBAR tool includes outlining the issue, providing background information, assessing the situation, and making a recommendation.

Goal Three: Maintaining the Safety of High-Alert Medications

• Medication safety is a key component of delivering high-quality care.
• Staff nurses should recognize the ten rights of medication administration: right medication, right patient, right time, right dose, right route, right documentation, right to refuse, right history and assessment, right drug-drug interaction, and right education and information.

Goal Four: Ensure Correct Site, Correct Procedure, and Correct Patient Surgery

• The operating room is a high-risk environment for patient safety.
• Procedures to improve patient safety before surgery include verification of patient identity, procedure, and site, labeling the surgical site, and taking a time-out to discuss and confirm the patient's identity, surgical site, and procedure.

Goal Five: Reducing the Risk of Healthcare-Associated Infections

• Healthcare-associated infections (HAIs) are a major patient safety issue.
• HAIs can be reduced by implementing infection prevention and control measures, such as environmental cleaning, linen handling, personal protective equipment, and hand washing.

Goal Six: Reducing the Risk from Fall

• Falls are a common occurrence in healthcare settings, particularly among geriatric patients.

• Measures to reduce the risk of falls include assessing patients' risk of falling, implementing fall prevention strategies, and providing education to patients and families.### Patient Falls in Hospital Settings

• Patient falls account for around one-third of hospital adverse events, resulting in significant consequences, including higher healthcare expenses and longer hospital stays.

• Falls are the number one adverse event in hospital settings, posing a significant risk to global public health.

• Interdisciplinary teams are used to direct procedures and approaches in evidence-based practices for fall prevention.

• Patient safety is a collective responsibility, requiring education of all clinical and non-clinical staff on inpatient fall prevention to establish a safety culture.

Fall Prevention Efforts

• Accreditation and quality improvement organizations, such as The Joint Commission and the Agency for Healthcare Research and Quality (AHRQ), highlight the issue and have ongoing efforts to reduce harm from falls.
• Preventing falls can improve patient outcomes and reduce financial burdens to healthcare organizations.
• Using the assessment tool for falls, such as the Morse Falls Scale, is highly helpful in determining the possible risk of falls in order to reduce fall incidences in the hospital.

Staff Nurse Responsibilities

• Staff nurses should assess their patients' risk of falling and take precautions to minimize that risk.
• Nurses play a crucial role in preventing falls and ensuring patient safety in hospital settings.